Utility of the Montreal Cognitive Assessment and Mini-Mental State Examination in predicting general intellectual abilities. Top mental health tools all in one place. WebThe Test of Premorbid Functioning (ToPF), a word reading test co-normed with the Wechsler Adult Intelligence Scale 4 th Edition (WAIS-IV), was examined as a tool for Both TBI groups experienced at least some degree of initial cognitive impairment on traditional neuropsychological measures (TMT, CVLT-II) with notable improvement over the first year. We also consider an abbreviated form of the NART (mini-NART, McGrory, Austin, Shenkin, Starr, & Deary, Citation2015), developed in order to expedite the test and remove words that provide little additional predictive power. MeSH The regression equations were as follows: NART predicted WAIS-IV FSIQ=.9775 NART error+126.41, WTAR predicted WAIS-IV FSIQ=1.2206 WTAR error+119.63. Demographic information was recorded (age, gender, years of education, occupation), with social class determined by occupation using the Office of Population, Censuses and Surveys (Citation1980) British classification, which ranges from 1 (professional) to 5 (unskilled). Typically, school leaving age of 16 corresponds to level I, 18 to level II; levels III and IV included participants currently undertaking that level of study. With large samples, however, reliable stimulus-specific coefficients can be computed in which the predictive value of each stimulus is individually weighted. Not designed to diagnose reading disorder. The development of standardised tools such as the NART and WTAR has undoubtedly improved the ability to predict meaningful baseline levels of performance so that the impact of a neurological condition on cognition can be judged. Results Approaches based on the NART, in particular, remain popular with many researchers and clinicians in the UK, USA, Canada and Australia, but even though the Test of Premorbid Function (TOPF) was designed to supersede the WTAR, the WTAR remains widely used. 5 Howick Place | London | SW1P 1WG. Would you like email updates of new search results? Psychological Corporation] for WTAR, and combined counts from [Pearson (Citation2009). For example, the shared variance (r2) between Vocabulary and Block Design scaled scores was less than 10%, rising to 12% for the combined hold measure. In most cases PF must be estimated, and specific tests have been designed to produce these estimates. Clin Neuropsychol. (, Mathias, J. L., Bowden, S. C., Bigler, E. D., & Rosenfeld, J. V. (, McGurn, B., Starr, J. M., Topfer, J. measure of premorbid intelligence. Brasure, M., Lamberty, G. J., Sayer, N. A., Nelson, N. W., Macdonald, R., Ouellette, J., et al. We computed regression equations for NART and WTAR scores against each of the WAIS-IV indices (excluding PSI, which was poorly correlated, as described above). Comparison of WTAR-predicted IQ and neuropsychological test standard scores over time for participants separated by injury severity. While those with mTBI performed approximately 1 SD below the controls on all measures at baseline, those with msevTBI had severely impaired performance at least 2.5 SDs below the mean of healthy controls. Earn money by contributing to product development, Booklets, record forms, answer sheets, report usages & subscriptions, Manuals, stimulus books, replacement items & other materials, Includes Manual (Print), 25 Report forms (Print) with pre-paid Q-global score reports (Digital), TOPF laminated Word List card (Print). This methodology has been used previously in TBI samples to provide evidence that word-reading tests are valid in the context of cognitive recovery (Green et al., 2008; Orme, Johnstone, Hanks, & Novack, 2004). CVLT-II = California Verbal Learning Test, 2nd Edition; mTBI = mild traumatic brain injury; msevTBI = moderate-to-severe traumatic brain injury; WTAR = Wechsler Test of Adult Reading. Researchers and clinicians working with UK populations who employ NART or WTAR may therefore wish to consider applying our equations in order to compare actual and predicted premorbid WAIS-IV (rather than WAIS-R/WAIS-III) performance. Permission will be required if your reuse is not covered by the terms of the License. Although both TBI groups improved over time, those with msevTBI continued to be impaired relative to controls at 1 year post-injury. (, Orme, D. R., Johnstone, B., Hanks, R., & Novack, T. (, Triebel, K. L., Martin, R. C., Novack, T. A., Dreer, L., Turner, C., Pritchard, P. R., et al. WebThe Test of Premorbid Functioning (TOPF) is a revised and updated version of the Wechsler Test of Adult Reading clinicians to estimate an individual's level of intellectual Correlation coefficients, although significant, were relatively small, even though statistical power (1 - ) in all cases exceeded .8 (two-tailed). WebPremorbidity. This work was supported by the National Institute on Child Health and Human Development [grant no. Predicted General Ability Index (GAI)=.9656 NART errors+126.5Predicted Verbal Comprehension Index (VCI)=1.0745 NART errors+126.81Perceptual Reasoning Index (PRI)=.6242 NART errors+120.18Working Memory Index (WMI)=.7901 NART errors+120.53, Predicted General Ability Index (GAI)=1.2025 WTAR errors+119.77Predicted Verbal Comprehension Index (VCI)=1.4411 WTAR errors+120.25Perceptual Reasoning Index (PRI)=.6931 WTAR errors+115.06Working Memory Index (WMI)=.9579 WTAR errors+114.78. The .gov means its official. They concluded that the WTAR is a valid estimate of premorbid intelligence in a recovering moderate-to-severe TBI population. The raw score can be transformed to an age-adjusted standard score, which is used to predict IQ (M = 100; SD = 15). The validity of this test depends on Please note that the item can still be purchased. The ToPF/demographic predicted FSIQ accounted for a significant proportion of variability in actual FSIQ, above and beyond that accounted for by education or time since injury. Results indicate that word-reading tests may underestimate premorbid intelligence during the immediate recovery period for patients with msevTBI. Stepwise regression using standard inclusion (p=.05) and exclusion (p=.1) criteria indicated that the best model in all cases contained two predictor variables (with the demographic variable explaining an additional 5% of the variance in FSIQ scores). In the WAIS batteries, Vocabulary, Matrix Reasoning, Information and Picture Completion subtests are those least likely to be affected by brain damage (e.g., Donders, Tulsky, & Zhu, Citation2001; Wechsler, Citation1997), and are therefore considered to be embedded hold tests, against which those subtests more sensitive to damage (the no-hold tests) can be compared. By closing this message, you are consenting to our use of cookies. Accurate prediction of premorbid functioning is important in neuropsychological assessment. Clinically, patients with msevTBI initially have WTAR-estimated IQ in the low average range and improve into the average range by 1 year; however, their performance remains significantly below that of their peers. Online ahead of print. Neuropsychological assessments are helpful in tracking changes that may affect daily functioning as cognitive impairment and dementia progress. Clinicians are encouraged to administer the entire WAIS-IV, or at minimum the VCI subtests, for a more accurate measure of intelligence in those with above average intelligence and history of TBI. Although this mean change did not meet criteria for a clinically significant difference in testretest scores according to the Wechsler (2001) manual (>10.8 point difference), it should be noted that 23% individuals with msevTBI did meet this cutoff. Bold values indicate significance at p < .05. The main NART/WAIS-IV correlations and regression equations have previously been published (Bright et al., Citation2016) but have been included to facilitate comparison with WTAR and alternative methods presented here. Although the relative utility and accuracy of these tests for many neurological conditions is unknown, Bright et al. Participant demographics and WAIS-IV performance are shown in Table 1. Notes: All scores are age-corrected standard scores based on normative data in the test manuals (except the MMSE, which is raw score). It is most often used in relation to psychological function (e.g. These tests should not be used to infer premorbid processing speed. Subsequent post hoc tests revealed that the msevTBI group had a greater proportion of men than those with mTBI (2=6.516, p=.011) and controls (2=5.120, p=.024). PMC Performance on the WTAR was also compared with neuropsychological measures known to be sensitive to the effects of head injury in order to assess the stability of word reading relative to other cognitive domains likely to display improvement during the post-acute phase. Epub 2019 Sep 17. The FSIQ range was 80 to 150, with an arithmetic mean of 108.52 and standard deviation of 12.71. The CVLT-II Forced Choice was administered to assess effort/test validity. Future studies including a higher number of severity groups will help to elucidate at what point on the TBI severity spectrum reading ability tests begin underestimating premorbid intelligence. Includes a list of 70 words that have atypical grapheme to phoneme translations. Linear correlation between National Adult Reading Test/Wechsler Test of Adult Reading (NART/WTAR) errors and Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) full-scale IQ (FSIQ). Processing speed (PSI) has been excluded. Epub 2019 Nov 13. Significantly better performance was observed on the WTAR than the NART [t(91)=19.98, p<.001], indicating both that the NART is the more difficult test, and that discrimination among more cognitively capable individuals on the basis of WTAR performance may be problematic as a result of possible ceiling effects (Table 3). Assessment. Registered in England & Wales No. Of note, within the msevTBI group, change in raw WTAR score was significantly correlated with change in all three neuropsychological variables. However, studies assessing the reliability of this measure in a recovering TBI population are limited and have had inconsistent results. B., et al. Google Scholar (5 October 5 2017) citation counts based on [Nelson and Willison (Citation1991). For more information please visit our Permissions help page. Copyright 2010 NCS Pearson, Inc. All rights reserved. Premorbidity refers to the state of functionality prior to the onset of a disease or illness. Data for the 23 items comprising the mini-NART (McGrory et al., Citation2015) were extracted to provide an overall score on this abbreviated version of the test. Please enable it to take advantage of the complete set of features! Individuals with a prior mTBI were included if their previous injury occurred at least 1 year before enrollment. Additionally, scores on the VCI and PRI subtests contribute to a General Ability Index (GAI), typically employed in cases in which disproportionate working memory and/or processing speed difficulties complicate the interpretation of FSIQ (Wechsler, Citation2008). These models were developed to predict scores on particular IQ tests (e.g., This site needs JavaScript to work properly. Bookshelf B., Gordon, W.A., et al. 2022 Sep 22;8(1):e12348. The raw score can be transformed to an age-adjusted standard score, which is used to predict IQ (M=100; SD=15). WebThe Test of Premorbid Functioning enables clinicians to estimate an individuals level of cognitive and memory functioning before the onset of injury or illness. Shura RD, Ord AS, Martindale SL, Miskey HM, Taber KH. Objective: The Wechsler Test of Adult Reading (WTAR) is a neuropsychological assessment tool used to provide a measure of premorbid intelligence, the degree of Intellectual function prior to the onset of illness or disease. The basic score on any test is the raw score, which is simply the UK: Pearson Corporation] for ACS/TOPF. Keywords: To determine the viability of using a straightforward best performance approach to estimating premorbid IQ, we assessed variability in performance across WAIS-IV subtests and indices in our neurologically healthy sample. Due to the relatively small sample size, we were unable to separate the mild and the complicated mild TBI groups or the moderate and severe TBI groups. Hsieh et al (2014) identified two cutoffs: 1) 25/30 has both high sensitivity and specificity and 2) 21/30 is almost In addition to the WTAR, all participants were administered a standardized battery of neuropsychological tests. Such underestimation could adversely affect brain injury rehabilitation and treatment planning as patients could be prematurely determined to have returned to baseline and discontinued from care. All levels of occupation and education were represented. (, Delis, D., Kramer, J., Kaplan, E., & Ober, B. Some authors have, in response to this problem, developed a correction to be applied to such estimates that uses demographic (and other) information, but have not satisfactorily resolved the tendency towards premorbid IQ overestimation (Powell, Brossart, & Reynolds, Citation2003). An official website of the United States government. Typically, the clinician infers general premorbid ability on the basis of the one or two best WAIS-IV subtest scores, but given the considerable variability among the subtests observed in healthy populations, it is acknowledged that this approach is likely to significantly overestimate premorbid ability (Franzen et al., Citation1997; Griffin, Mindt, Rankin, Ritchie, & Scott, Citation2002; Mortensen, Gade, & Reinisch, Citation1991; Reynolds, Citation1997). (, Oxford University Press is a department of the University of Oxford. Neuropsychological Assessment Battery, Judgment Subtest. Reale-Caldwell A, Osborn KE, Soble JR, Kamper JE, Rum R, Schoenberg MR. Appl Neuropsychol Adult. San Antonio, TX: Psychological Corporation.). Knowledge of intelligence is essential for interpreting cognitive performance following traumatic brain injury (TBI). In this paper, we consider a range of common methods for producing this estimate, including those based on current best performance, embedded hold/no-hold tests, demographic information, and word reading ability. In contrast, those participants with mTBI did not significantly differ from healthy controls and both the mTBI and control groups demonstrated stability on the WTAR over time. Correlations between the combined hold and no-hold measurements were larger, but even the combination of four no-hold tests explained only 35% of the variance of the combined hold measure. eCollection 2022. Procedures were approved by the University ethics panel and followed the tenets of the Declaration of Helsinki. Published by Oxford University Press. For example, performance on tests such as the NART and WTAR is unlikely to be entirely insensitive to neurological impairment, and the degree of sensitivity is likely to differ from one patient and/or condition to another. Test of Premorbid Functioning: You're Doing It Wrong, but Does It Matter? These include best performance (Lezak, Citation1995), hold/no-hold (Wechsler, Citation1958), demographics (e.g., Barona, Reynolds, & Chastain, Citation1984; Crawford & Allan, Citation1997), reading ability (e.g., Nelson, Citation1982; Nelson & Willison, Citation1991; Wechsler, Citation2001), and combinations thereof (e.g., Crawford, Nelson, Blackmore, Cochrane, & Allan, Citation1990; Vanderploeg, Schinka, & Axelrod, Citation1996). The current study sought to determine whether the Wechsler Test of Adult Reading (WTAR) provides a stable estimate of premorbid intellectual ability in acutely injured patients recovering from traumatic brain injury (TBI). Nevertheless, we observed considerable variability in correlations between NART/WTAR scores and individual WAIS-IV indices, which indicated particular usefulness in estimating more crystallised premorbid abilities (as represented by the verbal comprehension and general ability indices) relative to fluid abilities (working memory and perceptual reasoning indices). Spreen and Strauss (2006) noted that WTAR scores are highly correlated with measures of verbal IQ (r=.75) and full scale IQ (r=.73). Written informed consent was obtained from each participant or a legally authorized representative. The Test of Premorbid Functioning (TOPF), a revision of the Wechsler Test of Adult The value of the NART and WTAR for estimating WAIS-IV index scores is more questionable, showing large correlations with the VCI and GAI but relatively modest correlations with WMI and PRI, suggesting that caution should be employed in drawing inferences about premorbid executive function and fluid ability. Use of the TOPF as was designed is recommended. Number of academic publications in which NART-R (solid line), WTAR (dashed line) and Advanced Clinical Solutions/Test of Premorbid Functioning (ACS/TOPF) (dotted line) neuropsychological tests were cited for each year from 2011 to October 2017. Moreover, the msevTBI group's performance improved from baseline (M=23.4; SD=13.20) to 12 months post-injury (M=26.88; SD=12.05), t(39)=2.19, p<.05, d=.35. However, there are few published methods currently available that have been standardised against the most recent revision of the Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, Citation2008). Comparison of methods for estimating pre . https://doi.org/10.1080/09602011.2018.1445650, https://doi.org/10.1037/0022-006X.52.5.885, http://doi.org/10.1080/09602011.2016.1231121, https://doi.org/10.1017/S1355617702860131, https://doi.org/10.1080/13854049708407050, https://doi.org/10.1017/S0033291701003634, https://doi.org/10.1016/0191-8869(90)90028-P, https://doi.org/10.1016/0191-8869(89)90043-3, https://doi.org/10.1016/S0887-6177(01)00136-6, https://doi.org/10.1080/00050060600827599, https://doi.org/10.1016/S0887-6177(02)00135-X, https://doi.org/10.1016/S0887-6177(97)00051-6, https://doi.org/10.1080/13854049708407043, https://doi.org/10.1080/09602011.2012.747968, https://doi.org/10.1037/1040-3590.8.4.404, https://doi.org/10.1016/j.cbpra.2013.12.005. WebEstimates of premorbid intelligence obtained from the TOPF and WRAT-4 READ have a strong linear relationship, but systematically generate inconsistent estimates in a neurodegenerative disease clinical sample and should not be used interchangeably. Mixed ANOVAs were used to determine whether healthy controls, patients with mTBI, and patients with msevTBI performed differently on the WTAR, TMT, and CVLT-II Trials 15 Total between baseline and 1 year following injury. An opportunity sample of 100 neurologically healthy adults (mean age 40 years; range 18 to 70; SD 16.78) were recruited primarily from university campuses in Cambridge and London, local retail environments and via social media, of which eight participants failed to complete one or more tests and were excluded from all analyses. WebTest of Premorbid Functioning (TOPF)-Raw Score : FITBIR : Federal Interagency Traumatic Brain Injury Research Informatics System Start of main content Unique Data Element: Test of Premorbid Functioning (TOPF)-Raw Score General Details Basic Attributes Classifications Keywords and Labels Specific Details Change History Four separate indices were introduced with WAIS-IV, replacing the verbal and performance subscales included in previous versions of the test battery: Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI) and Processing speed (PSI). Moreover, the msevTBI group had a significant improvement in WTAR performance over the 1-year period. sharing sensitive information, make sure youre on a federal Table 6 provides FSIQ estimates on the basis of the single and two variable models at three levels of the relevant demographic measure. Purpose. NFER-Nelson] for NART-R; [Wechsler (Citation2001). HHS Vulnerability Disclosure, Help Those with msevTBI have a predicted IQ that is 13 points lower than healthy controls at 1 month post-injury and improve an average of 5 IQ points upon second testing a year later. Note: Values are meanSD. All participants were recruited and tested between 2013 and 2016, in a UK university setting. Nevertheless, the scarcity of very low WTAR scores in our sample suggests that these lower FSIQ estimates should be interpreted with caution. Participants with mTBI did not significantly differ from healthy controls at any time during the 1-year period, and both the mTBI and control groups demonstrated stability on the WTAR over time. 2020 Jan;34(1):43-52. doi: 10.1037/neu0000569. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. In addition, paired sample t-tests were used to assess for within-group effect of time for each group. Results: 2000 Feb;14(1):139-45. doi: 10.1076/1385-4046(200002)14:1;1-8;FT139. (, Evaluation of the accuracy of two regression-based methods for estimating premorbid IQ, Postscripts on premorbid ability estimation: Conceptual addenda and a few words on alternative and conditional approaches, Oklahoma premorbid intelligence estimation (OPIE): Utilization in clinical samples, Impaired National Adult Reading Test (NART) performance in traumatic brain injury, Estimation of WAISR premorbid intelligence: Current ability and demographic data used in a best-performance fashion, Clinical guide to the evidence-based assessment approach to diagnosis and treatment. Figure 3 presents scatterplots relating NART error to index scores. There were no missing data across the sample of 92 participants for any variable, with the exception of social class (missing for 14 participants, as indicated in Table 1). WebTest of Premorbid Functioning Estimates amount of cognitive functioning lost due to brain injury. Data were retrospectively analyzed on persons with TBI (n=83) who were enrolled from the University of Alabama at Birmingham (UAB) hospital system between 2007 and 2011 as part of a larger NIH-funded longitudinal study investigating medical decision making in TBI (Triebel et al., 2012). Read the case study. Two of these measures were chosen for analyses as they assess areas of cognition known to be sensitive to the effects of head injury (Rabinowitz & Levin, 2014): Trail Making Test (TMT), Part A and B (Reitan & Wolfson, 1993), and the California Verbal Learning Test-II (CVLT-II) Trials 15 Total (Delis, Kramer, Kaplan, & Ober, 2000). Ideal for clinicians wishing to develop appropriate treatment plans. Test of Premorbid Functioning They concluded that the WRAT Reading subtest underestimates premorbid functioning in those with more severe head injuries during the acute recovery period. Inclusion of education with WTAR is more problematic, since we cannot know what the maximum educational level achieved will be for the younger participants in our sample (i.e., some participants were in full-time education and/or may not have reached their peak level of achievement at the time of testing). Individuals with penetrating brain injuries (e.g., gunshot wound) were excluded from the study. Fifty-two participants with mild, moderate, or severe TBI were administered the ToPF and WAIS-IV between two weeks and 19 months post-injury. Such variability in neurologically healthy participants renders estimation of premorbid IQ using a straightforward best performance approach problematic, and likely to produce markedly inflated predicted scores. The severe TBI group had significantly lower WTAR scores at the first assessment and all groups improved over time. A total of 135 participants (43 mild TBI [mTBI], 40 moderate/severe TBI [msevTBI], 52 healthy controls) were administered the WTAR at 1 and 12 months post-injury. All were British nationals, with English as the first language, and with normal/corrected-to-normal vision and hearing. Descriptive analyses, ttests, and chi-squared tests were utilized to identify and compare cognitive profiles.
Church Trustees Legal Responsibilities,
Articles T